Abstract
The aim of this study was to evaluate the indications, outcomes and limitations of OK-432 sclerotherapy in various otolaryngological cystic diseases. We analyzed the data of 148 patients with otolaryngological cystic diseases who had undergone OK-432 sclerotherapy. Of these patients, 48 (32%) had a plunging ranula, 14 (9%) had a lymphangioma, 12 (8%) had a branchial cleft cyst, 15 (10%) had a thyroglossal duct cyst, 11 (7%) had a thyroid cyst, 3 (2%) had a cervical lymphocele after neck dissection for head and neck cancer, 23 (16%) had a salivary mucocele, and 22 (15%) had an auricular hematoma. In the cases with a plunging ranula, lymphangioma, branchial cleft cyst, thyroglossal duct cyst, thyroid cyst or cervical lymphocele, we aspirated as much of the fluid content of the cystic lesion as possible, and replaced the aspirated fluid with about half the volume of OK-432 solution. In the cases with a salivary mucocele or auricular hematoma, we prepared a 0.5-Klinische Einheit (KE) of OK-432 diluted with 0.2 ml saline solution and injected this OK-432 solution into the lesion via a 27G needle to prevent leakage of the agent from the lesion. Complete disappearance of the lesion was observed in 119 of the 148 patients (80%). On the other hand, marked reduction was observed in 20 of the 148 patients (14%), partial reduction in 3 patients (2%) and no response was seen in 6 patients (4%). The responses to OK-432 therapy were better in the cases with a plunging ranula, lymphangioma, thyroglossal duct cyst, thyroid cyst, auricular hematoma or salivary mucocele than in those with a branchial cleft cyst. Local discomfort at the injection site and fever were observed as side effects in 68 (46%) and 61 (41%) of the patients, respectively, however, there were no cases of serious complications of OK-432 therapy, and the therapy seemed to have no influence on any future surgery. We undertook OK-432 therapy on an outpatient basis without hospitalization in all cases, except for the few who had the potential risk of airway obstruction. Our results confirmed that OK-432 therapy is a simple, easy, safe and effective therapeutic modality that can be used as a substitute for surgery in the treatment of various otolaryngological cystic diseases.
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